Advocacy Toolkit: Revising License and Credentialing Applications to Not Ask About Mental Health

Published 1/21/2022

In 2018, the Federation of State Medical Boards (FSMB) adopted a policy recommending that state boards approach physician wellness and burnout from a nonpunitive perspective, evaluating whether it is necessary to ask probing questions about mental health, addiction, or substance use, particularly in the applicant's past.

Included in this toolkit are tools and resources that clinicians can use to advocate for organizations and state medical boards to change or remove inappropriate medical licensing and application questions that perpetuate the stigma about receiving mental health care or having a mental health diagnosis, resulting in physicians not receiving care.

Please contact acpwellbeing@acpprograms.org with questions or for additional resources.

• Example/Template Letter to Share with Your Organization or Medical Board to Change or Remove Inappropriate Mental Health Questions on Credentialing or Medical License Applications
  • Example/Template Letter for a Medical Board
  • Example/Template Letter for a Credentialing Committee
• Example/Template PowerPoint to Make the Case  to Change or Remove Inappropriate Mental Health Questions on Credentialing or Medical License Applications
  • Example/Template Powerpoint
• Contact a State Medical Board
• Contact (including e-mail) a Federal or State Elected Official
• Additional Background:
  • According to a study published as a research letter in May 2021 by JAMA. Thirty-nine states limited questions on initial licensing applications to current conditions with impairment
  • ACP Internist: Protective equipment for physicians' mental health
  • Modern Healthcare: The connection between credentialing and physician mental health: a call to action

References

1. Lai  J, Ma  S, Wang  Y,  et al.  Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019.   JAMA Netw Open. 2020;3(3):e203976.
2. Dyrbye  LN, West  CP, Sinsky  CA, Goeders  LE, Satele  DV, Shanafelt  TD.  Medical licensure questions and physician reluctance to seek care for mental health conditions.   Mayo Clin Proc. 2017;92(10):1486-1493.
3. James T.R. Jones, Carol S. North, Suzanne Vogel-Scibilia, Michael F. Myers, Richard R. Owen. Medical Licensure Questions About Mental Illness and Compliance with the Americans With Disabilities Act. J of the Am Acad of Psych and the Law Online Dec 2018, 46 (4) 458-471; DOI: 10.29158/JAAPL.003789-18
4. Federation of State Medical Boards. Physician Wellness and Burnout. Published April 2018. Accessed March 16, 2021. https://www.fsmb.org/siteassets/advocacy/policies/policy-on-wellness-and-burnout.pdf
5. Saddawi-Konefka D, Brown A, Eisenhart I, Hicks K, Barrett E, Gold JA. Consistency Between State Medical License Applications and Recommendations Regarding Physician Mental Health. JAMA. 2021;325(19):2017–2018. doi:10.1001/jama.2021.2275
6. Story J, Solberg D. Barriers to Mental Illness and Substance Abuse Treatment Among Physicians and the Impact on Patient Care. Mo Med. 2017;114(2):91-93.
7. Barrett, E, Lawrence, E, Waldman, D, Brislen, H. Improving How State Medical Boards Ask Physicians About Mental Health Diagnoses: A Case Study from New Mexico. Ann Intern Med 172:617–618, 2020.
8. Barrett, E., Hingle, S. T., Smith, C. D., & Moyer, D. V. (2021). Getting Through COVID-19: Keeping Clinicians in the Workforce. Annals of internal medicine, 174(11), 1614–1615. https://doi.org/10.7326/M21-3381